Most counties don’t have their own health agencies, and some specific population groups have low vaccination rates

Pennsylvania is bracing for a wave of measles cases, with some public health officials concerned that it’s “only a matter of time” until the disease spreads beyond the outbreak’s epicenter.

Last week the state reported its fifth measles-associated death amid 943 confirmed cases across 39 counties. The outbreak comes amid concerns that public health in the US has been hit by increasing vaccine skepticism, especially due to the power and influence of controversial health secretary Robert F Kennedy Jr.

Pennsylvania has reported over 900 measles cases and four deaths as governor and health chief RFK Jr spar over data

A second measles death in the US has been announced on Tuesday by the federal Centers for Disease Control and Prevention (CDC), as the country grapples with an outbreak affecting 47 states.

As of 24 September, a total of 3,659 measles cases have been confirmed by the CDC, with the two deaths having been confirmed on Tuesday. The confirmation did not specify in which states the deaths had occurred.